Emetophobia: Anxiety about Vomiting

What is it?

A disproportionate fear of vomiting, or emetophobia, is a chronic and disabling condition characterized by avoidance of a wide array of situations or activities that have an increased risk of vomiting. It can include a fear of other people vomiting and is generally associated with an overwhelming sense of losing control, becoming ill, or that others will find them repulsive. It is a relatively common anxiety condition that can begin at any time, and is often (but not always) triggered by a negative experience with vomiting such as food poisoning, being in public at the time, or prolonged exposure to vomiting. Emetophobia can have a profound impact on a person’s quality of life, but also impact their relationships with others due to severe avoidance or an inability to show care and compassion to those who are unwell.

What are the signs and symptoms?

Emetophobics often avoid situations or activities that they believe increases the risk of vomiting. This can include crowded places with limited exit routes (e.g., planes, boats, shops), public transport, and unfamiliar places. It can also lead to avoidance of people such as sick relatives or unwell children, people who are consuming alcohol, or anyone else at risk of vomiting. The fear of vomiting can lead to refusal to attend medical appointments or dentists, take medication, or restrictive eating leading to weight loss and health related issues.

Other symptoms can include:

  • Avoiding seeing vomiting on TV or in movies
  • Obsessing over locations of restrooms
  • Avoiding smells or objects that are disgusting
  • Avoiding hospitals and sick people
  • Avoiding previously visited places that caused nausea
  • Avoiding eating food not prepared at home
  • Inability to speak or hear the word vomit
  • Unable to listen to sounds of vomiting
  • Hypervigilance to bodily sensations that may indicate the likelihood of vomiting (e.g., nausea, butterflies)

How do we treat Anxiety about Vomiting?

Emetophobia can be treated using Cognitive Behavioural Therapy (CBT) and Exposure with Response Prevention (ERP). Together, this can help you identify your unhelpful, irrational, and negative thoughts about vomiting and develop techniques to challenge these thoughts. ERP helps you confront your fear in a safe and supportive environment with a trained professional. By developing a list of stimuli you have identified as fear provoking, you can gradually desensitize your urge to avoid previously feared situations. This allows you to regain control of your fear, developing helpful coping strategies, and replace your old reactions with new positive and rational thoughts, feelings, and behaviours.

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